Case Reports
16 June 2025
Vol. 3 No. 1 (2025)
https://doi.org/10.4081/aapm.2025.45

Hip arthroplasty under pericapsular nerve group blocks combined with local anesthesia: a report on three different surgical techniques

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Hip replacement arthroplasty, nerve block, conduction anesthesia, local anesthesia, regional anesthesia, PENG block
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Authors

Romualdo Del Buono
romualdo.delbuono@asst-pini-cto.it
Unit of Anesthesia, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy.
Giuseppe Pascarella
Unit of Anesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University, Rome, Italy.
Fabio Costa
Unit of Anesthesia, Intensive Care and Pain Management, Department of Medicine, Campus Bio-Medico University, Rome, Italy.
Gaetano Terranova
Unit of Anesthesia, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy.
Andrea Tognù
Unit of Anesthesia, Intensive Care and Pain Management, ASST Gaetano Pini, Milan, Italy.

Hip arthroplasty and endoprosthesis surgery typically utilize general or spinal anesthesia, but regional techniques like the PENG block offer potential analgesic benefits. This report presents three cases in which a modified ultrasound-guided pericapsular infiltration technique is used as the only technique for hip surgery. Three patients undergoing hip arthroplasty/endoprosthesis surgery with different approaches (direct anterior, lateral, and posterolateral) received ultrasound-guided anterior and posterior pericapsular injections (A-PENG and PONG) and additional local anesthetic infiltration tailored to the surgical approach. All patients experienced successful intraoperative anesthesia and adequate postoperative analgesia within 24 hours, with no motor block. The technique was adaptable to different approaches and patient characteristics. This case series suggests the feasibility and potential benefits of the pericapsular nerve blocks as a regional anesthesia option for hip surgery. Further research is needed to compare its efficacy, safety, and cost-effectiveness with other techniques in larger, controlled studies.

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Hip arthroplasty under pericapsular nerve group blocks combined with local anesthesia: a report on three different surgical techniques. (2025). Advances in Anesthesia and Pain Medicine, 3(1). https://doi.org/10.4081/aapm.2025.45
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